LEIK FNP LATEST 2026 TEST PAPER QUESTIONS AND
SOLUTIONS RATED A+
✔✔Body (GH) is targeted by - ✔✔somatic growth hormone
✔✔Uterus (oxytocin) is targeted by - ✔✔uterine contractions, bonding
✔✔Kidneys (vasopressin) is targeted by - ✔✔blood volume
✔✔pineal gland (melatonin) is targeted by - ✔✔circadium rhythm
✔✔breast (prolactin) is targeted by - ✔✔milk production
✔✔Hypothalamus works to - ✔✔Coordinates the nervous and endocrine system by
sending signals via the pituitary gland. The gland interacts to form the HPA axis.
Produces neurohormones that stimulate or stop production of pituitary hormones.
✔✔Pituitary Gland works to - ✔✔Stimulated by the hypothalamus into producing the
stimulating hormones such as FSH, LH, TSH, adrenocorticotropic hormone (ACTH),
and growth hormone (GH).
✔✔FSH: - ✔✔Stimulates the ovaries to enable growth of follicles (or eggs)
Production of estrogen
✔✔LH: - ✔✔Stimulates the OVARIES TO OVULATE.
Production of PROGESTERONE (by corpus luteum)
In males, LH stimulates the TESTICLES TO PRODUCE TESTOSTERONE
✔✔TSH - ✔✔Stimulates thyroid gland
Production of triiodothyronine (T3) and thyroxine (T4)
✔✔GH - ✔✔Stimulates somatic growth of the body
✔✔ACTH: - ✔✔Stimulates the adrenal glands (two portions of gland: medulla and
cortex)
Production of glucocorticoids (cortisol) and mineralocorticoids (aldosterone)
✔✔Prolactin: - ✔✔Affects lactation and milk production
✔✔Melanocyte-stimulating hormone: - ✔✔Production of melatonin in response to UV
light; highest levels at night between 11 p.m. and 3 a.m.
,✔✔Posterior Pituitary Gland - ✔✔Secretes antidiuretic hormone (vasopressin) and
oxytocin, which are made by the hypothalamus but stored and secreted by the posterior
pituitary.
✔✔Thyroid Gland - ✔✔A butterfly-shaped organ (two lobes) located below the
prominence of the thyroid cartilage (Adam's apple). It is 2 inches long, and the lobes are
connected by the isthmus. Uses iodine to produce T3 and t4
✔✔Parathyroid Glands - ✔✔Located behind the thyroid glands (two glands behind each
lobe). Produces parathyroid hormone (PTH), which is responsible for the calcium
balance of the body by regulating the calcium loss or gain from the bones, kidneys, and
gastrointestinal (GI) tract (calcium absorption).
✔✔pineal gland - ✔✔Pea-sized gland located inside the brain that produces melatonin.
Melatonin regulates the sleep-wake cycle. Darkness stimulates melatonin production,
and light suppresses it.
✔✔Thyroid scan (24-hour thyroid scan with RAIU): - ✔✔Shows metabolic activity of
thyroid gland
✔✔Cold spots in bone scan - ✔✔Not metabolically active (more worrisome; rule out
thyroid cancer); fine-needle aspiration biopsy
✔✔Hot spot: - ✔✔Metabolically active nodule with homogeneous uptake; usually
benign; helpful in diagnosing recurrent disease
✔✔TSH (thyroid-stimulating hormone or thyrotropin): levels - ✔✔Normal range: TSH of
0.5 to 5.0 mU/L (third-generation test).
TSH is used for both screening and monitoring response to treatment.- Recheck TSH
every 6 to 8 weeks. Dose of levothyroxine (Synthroid) is based on the TSH level. Goal
is a TSH <5.0 mU/L.- When TSH is stable, recheck every 6 to 12 mont
✔✔labs hypothyroidism - ✔✔tsh->5.0 mU/L
free t4 low (normal 0.8 to 1.8 nanograms per deciliter (ng/dL).
t3 is low (normal 60 to 180 nanograms per deciliter (ng/dL), or 0.9 to 2.8 nanomoles per
liter (nmol/L)
✔✔labs Subclinical hypothyroidism - ✔✔tsh->5.0 mU/L
Free t4-normal (normal 0.8 to 1.8 nanograms per deciliter (ng/dL)
t3- normal (normal 60 to 180 nanograms per deciliter (ng/dL), or 0.9 to 2.8 nanomoles
per liter (nmol/L)
, ✔✔labs Hyperthyroidism - ✔✔tsh-<0.4 mU/L
Free t4-High ((normal 0.8 to 1.8 nanograms per deciliter (ng/dL)
t3-High (normal 60 to 180 nanograms per deciliter (ng/dL), or 0.9 to 2.8 nanomoles per
liter (nmol/L)
✔✔Primary Hyperthyroidism (Thyrotoxicosis) - ✔✔The classic finding is a very low (or
undetectable) TSH with elevations in both serum-free T4 and T3 levels. The most
common cause for hyperthyroidism (60%-80%) in the United States is a chronic
autoimmune disorder called Graves' disease.
✔✔Graves' Disease - ✔✔Graves' disease accounts for 60% to 80% of all types of
hyperthyroidism. An autoimmune disorder causing hyperfunction and production of
excess thyroid hormones (T3 and T4). Higher incidence in women (7:1 ratio). These
women are also at higher risk for other autoimmune diseases such as rheumatoid
arthritis (RA) and pernicious anemia (PA) and for osteopenia/osteoporosis due to
increased metabolism.
✔✔Graves Classic Case - ✔✔Middle-aged woman loses a large amount of weight
rapidly with anxiety and insomnia. Cardiac symptoms (due to overstimulation) are
palpitations, hypertension, atrial fibrillation, or premature atrial contractions. Warm and
moist skin with increased perspiration. May present with ophthalmopathy and lid lag
(Graves' ophthalmopathy). More frequent bowel movements (looser stools).
Amenorrhea and heat intolerance. Enlarged thyroid (goiter) and/or thyroid nodules
present. May be accompanied by pretibial myxedema (thickening of the skin usually
located in the shins and gives an orange-peel appearance).
✔✔Graves objective findings - ✔✔Thyroid: Diffusely enlarged gland (goiter), toxic
adenoma, or multinodular goiter. May be tender to palpation or asymptomatic
Extremities: Fine tremors on both hands, sweaty palms, pretibial myxedema
Eyes: Lid lag; exophthalmos in one or both eyes
Cardiac: Tachycardia, atrial fibrillation, congestive heart failure, cardiomyopathy
Integumentary: Fine hair, warm skin
Neurologic: Brisk deep tendon reflexes
✔✔Graves labs - ✔✔very low TSH (<0.05 mU/L) with elevated serum-free T4 and T3. If
Graves' disease, will have positive thyrotropin receptor antibodies (TRAb), which is also
known as the thyroid-stimulating immunoglobulins (TSIs) . The thyroid peroxidase
antibody (TPO) is positive with Graves' disease as well as Hashimoto's disease.
✔✔Graves workup labs - ✔✔Workup: Check TSH. If low, order thyroid panel. Look for
very low TSH (<0.5 mU/L) with elevated serum-free T4 and elevated T3. (In some
patients with very low TSH, only either the serum T4 or the serum T3 will be elevated.)
SOLUTIONS RATED A+
✔✔Body (GH) is targeted by - ✔✔somatic growth hormone
✔✔Uterus (oxytocin) is targeted by - ✔✔uterine contractions, bonding
✔✔Kidneys (vasopressin) is targeted by - ✔✔blood volume
✔✔pineal gland (melatonin) is targeted by - ✔✔circadium rhythm
✔✔breast (prolactin) is targeted by - ✔✔milk production
✔✔Hypothalamus works to - ✔✔Coordinates the nervous and endocrine system by
sending signals via the pituitary gland. The gland interacts to form the HPA axis.
Produces neurohormones that stimulate or stop production of pituitary hormones.
✔✔Pituitary Gland works to - ✔✔Stimulated by the hypothalamus into producing the
stimulating hormones such as FSH, LH, TSH, adrenocorticotropic hormone (ACTH),
and growth hormone (GH).
✔✔FSH: - ✔✔Stimulates the ovaries to enable growth of follicles (or eggs)
Production of estrogen
✔✔LH: - ✔✔Stimulates the OVARIES TO OVULATE.
Production of PROGESTERONE (by corpus luteum)
In males, LH stimulates the TESTICLES TO PRODUCE TESTOSTERONE
✔✔TSH - ✔✔Stimulates thyroid gland
Production of triiodothyronine (T3) and thyroxine (T4)
✔✔GH - ✔✔Stimulates somatic growth of the body
✔✔ACTH: - ✔✔Stimulates the adrenal glands (two portions of gland: medulla and
cortex)
Production of glucocorticoids (cortisol) and mineralocorticoids (aldosterone)
✔✔Prolactin: - ✔✔Affects lactation and milk production
✔✔Melanocyte-stimulating hormone: - ✔✔Production of melatonin in response to UV
light; highest levels at night between 11 p.m. and 3 a.m.
,✔✔Posterior Pituitary Gland - ✔✔Secretes antidiuretic hormone (vasopressin) and
oxytocin, which are made by the hypothalamus but stored and secreted by the posterior
pituitary.
✔✔Thyroid Gland - ✔✔A butterfly-shaped organ (two lobes) located below the
prominence of the thyroid cartilage (Adam's apple). It is 2 inches long, and the lobes are
connected by the isthmus. Uses iodine to produce T3 and t4
✔✔Parathyroid Glands - ✔✔Located behind the thyroid glands (two glands behind each
lobe). Produces parathyroid hormone (PTH), which is responsible for the calcium
balance of the body by regulating the calcium loss or gain from the bones, kidneys, and
gastrointestinal (GI) tract (calcium absorption).
✔✔pineal gland - ✔✔Pea-sized gland located inside the brain that produces melatonin.
Melatonin regulates the sleep-wake cycle. Darkness stimulates melatonin production,
and light suppresses it.
✔✔Thyroid scan (24-hour thyroid scan with RAIU): - ✔✔Shows metabolic activity of
thyroid gland
✔✔Cold spots in bone scan - ✔✔Not metabolically active (more worrisome; rule out
thyroid cancer); fine-needle aspiration biopsy
✔✔Hot spot: - ✔✔Metabolically active nodule with homogeneous uptake; usually
benign; helpful in diagnosing recurrent disease
✔✔TSH (thyroid-stimulating hormone or thyrotropin): levels - ✔✔Normal range: TSH of
0.5 to 5.0 mU/L (third-generation test).
TSH is used for both screening and monitoring response to treatment.- Recheck TSH
every 6 to 8 weeks. Dose of levothyroxine (Synthroid) is based on the TSH level. Goal
is a TSH <5.0 mU/L.- When TSH is stable, recheck every 6 to 12 mont
✔✔labs hypothyroidism - ✔✔tsh->5.0 mU/L
free t4 low (normal 0.8 to 1.8 nanograms per deciliter (ng/dL).
t3 is low (normal 60 to 180 nanograms per deciliter (ng/dL), or 0.9 to 2.8 nanomoles per
liter (nmol/L)
✔✔labs Subclinical hypothyroidism - ✔✔tsh->5.0 mU/L
Free t4-normal (normal 0.8 to 1.8 nanograms per deciliter (ng/dL)
t3- normal (normal 60 to 180 nanograms per deciliter (ng/dL), or 0.9 to 2.8 nanomoles
per liter (nmol/L)
, ✔✔labs Hyperthyroidism - ✔✔tsh-<0.4 mU/L
Free t4-High ((normal 0.8 to 1.8 nanograms per deciliter (ng/dL)
t3-High (normal 60 to 180 nanograms per deciliter (ng/dL), or 0.9 to 2.8 nanomoles per
liter (nmol/L)
✔✔Primary Hyperthyroidism (Thyrotoxicosis) - ✔✔The classic finding is a very low (or
undetectable) TSH with elevations in both serum-free T4 and T3 levels. The most
common cause for hyperthyroidism (60%-80%) in the United States is a chronic
autoimmune disorder called Graves' disease.
✔✔Graves' Disease - ✔✔Graves' disease accounts for 60% to 80% of all types of
hyperthyroidism. An autoimmune disorder causing hyperfunction and production of
excess thyroid hormones (T3 and T4). Higher incidence in women (7:1 ratio). These
women are also at higher risk for other autoimmune diseases such as rheumatoid
arthritis (RA) and pernicious anemia (PA) and for osteopenia/osteoporosis due to
increased metabolism.
✔✔Graves Classic Case - ✔✔Middle-aged woman loses a large amount of weight
rapidly with anxiety and insomnia. Cardiac symptoms (due to overstimulation) are
palpitations, hypertension, atrial fibrillation, or premature atrial contractions. Warm and
moist skin with increased perspiration. May present with ophthalmopathy and lid lag
(Graves' ophthalmopathy). More frequent bowel movements (looser stools).
Amenorrhea and heat intolerance. Enlarged thyroid (goiter) and/or thyroid nodules
present. May be accompanied by pretibial myxedema (thickening of the skin usually
located in the shins and gives an orange-peel appearance).
✔✔Graves objective findings - ✔✔Thyroid: Diffusely enlarged gland (goiter), toxic
adenoma, or multinodular goiter. May be tender to palpation or asymptomatic
Extremities: Fine tremors on both hands, sweaty palms, pretibial myxedema
Eyes: Lid lag; exophthalmos in one or both eyes
Cardiac: Tachycardia, atrial fibrillation, congestive heart failure, cardiomyopathy
Integumentary: Fine hair, warm skin
Neurologic: Brisk deep tendon reflexes
✔✔Graves labs - ✔✔very low TSH (<0.05 mU/L) with elevated serum-free T4 and T3. If
Graves' disease, will have positive thyrotropin receptor antibodies (TRAb), which is also
known as the thyroid-stimulating immunoglobulins (TSIs) . The thyroid peroxidase
antibody (TPO) is positive with Graves' disease as well as Hashimoto's disease.
✔✔Graves workup labs - ✔✔Workup: Check TSH. If low, order thyroid panel. Look for
very low TSH (<0.5 mU/L) with elevated serum-free T4 and elevated T3. (In some
patients with very low TSH, only either the serum T4 or the serum T3 will be elevated.)
